Application and Testing the PRECEDE Model for Health Promotion of Air Crew

To define the factors related to health promotion behavior in aircrew of an airline, this study as a covariance structural analysis applied and tested PRECEDE model. In using the PRECEDE model, the purpose of this study was to assess by phase factors that influence health promotion of aircrews and to test the relationship between health promotion related factors and those of PRECEDE model. The data was collected for one month in April of 2001 using self-questionarire and medical records. The data of 218 subjects were analyzed. For general characteristics and each assessment SPSS 10.0 Win Program was used for analysis LISREL 8.12 Win Program was used to test model. 1. Application of PRECEDE model For health promotion of aircrew, PRECEDE model was applied. For epidemiological assessment, elevated serum total cholesterol was chosen. Smoking, drinking, exercise and diet were defined as behavior factor. Job stress and stress factors in aviation were defined as environmental factor. Predisposing factors were regular lifestyle habits(sleep time, dietary habits with three meals per day, breakfast and snack), health related self efficacy, perceived benefit, perceived barrier. Reinforcing factors, the social support network among peers was assessed. Duty depending on the type of work situation, either domestic or international and the number of days spent in a rural city or overseas were used as enabling factors. 2. Testing of the model The total of nine theoretical variable to test its validity was used. Exogenous variable were enabling factors of work situation. Endogenous variables were reinforcing factor of social support network, predisposing factor of regular lifestyle, self efficacy, perceived benefit and perceived barrier. Out of 16 hypothetical paths using such factors, only four were supported. In order to modify the model, 5 paths were added after eliminating of 4 and as a result 9 out of total 17 were supported. Direct Effects With the PROCEDE model, reinforcing factors had significant effect on predisposing factors [Regular lifestyle habits (beta21=8.728, t=2.742), self efficacy (beta31=7.461, t=2.947), perceived benefit (beta41=3.967, t=2.679), perceived barrier (beta51=-3.550, t=-2.955)]. Even after modifying the model in order to improve fitness reinforcing factors had significant direct effects on predisposing factors [Regular lifestyle habits (beta21=0.020, t=2.428), self efficacy (beta31=9.636, t=2.427), perceived benefit(beta41=4.425, t=2.229), perceived barrier (beta51=4.212, t=-2.451)]. Perceived barrier had significant direct effects on health problem (beta85=0.171, t=2.979). Perceived barrier had significant direct effects on environmental factor (beta75=0.035, t=2.257). Perceived benefit had significant direct effects on behavior factor (beta64=0.391, t=2.755). Indirect Effect Regular lifestyle habits had significant indirect effects on Endogenous variable [Self efficacy (effect coefficient=0.191, t=9.004), perceived benefit (effect coefficient=0.087, t=4.576), behavior factor (effect coefficient=1.108, t=2.703), perceived barrier (effect coefficient=-0.083, t=-5.130), environmental factor (effect coefficient=-0.007, t=-2.579), health problem (effect coefficient=-0.016, t=-3.138)]. Social support network had significant indirect effects on health problem (effect coefficient=-0.823, t=-2.083). In conclusion this study supports the PRECEDE model by Green (1980) and this was useful in health promotion model of aircrew. Therefore, in order to improve health problem related to hyperlipidemia in aircrew, behavior modification though peer support should be promoted initially and then, programs that emphasize increasing perceived benefit and decreased barrier should be promoted. Finally, modifying health behavior to promote regular lifestyle and decrease health problems is encouraged.

Model Development a Womens' Health Care Center in the Community / 간호학회지

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.